DR. AMY W WAGNER PH.D.
NPI 1003827965
Psychologist in Portland, OR

Active since August 10, 2006Opted out of Medicare · through Sep 4, 2027
3710 SW US VETERANS HOSPITAL RD, V3-SATP, PORTLAND, OR 97239(503) 220-8262(360) 737-1419 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Amy W Wagner Ph.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. AMY W WAGNER PH.D. (NPI 1003827965) is an individual psychologist in Portland, Oregon, licensed in Washington (2491) and active in the NPI registry since August 2006. She has opted out of Medicare through September 4, 2027.

NPPES Registry Identity

NPI1003827965
Entity TypeIndividualFemale
Primary Taxonomy103T00000X
Provider Legal NameDR. AMY W WAGNERCredential: PH.D.
Location Address3710 SW US VETERANS HOSPITAL RD, V3-SATPPortland, OR 97239-2964
Mailing Address4205 Nw Spruce StVancouver, WA 98660-1655 · (360) 750-0506
Fax(360) 737-1419
Sole ProprietorNo
Enumeration DateAugust 10, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1003827965 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in WA · 2491
Definition

A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.

3710 SW US VETERANS HOSPITAL RD, Portland, OR 97239

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Dr. Amy W Wagner Ph.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from September 4, 2025 through September 4, 2027.

Opt-Out Effective DateSeptember 4, 2025
Opt-Out In Effect ThroughSeptember 4, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
3710 SW US VETERANS HOSPITAL RD, PHARMACY DEPARTMENT
PORTLAND, OR 97239
Social Worker (Clinical)
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239
Psychiatry & Neurology (Geriatric Psychiatry)
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239
Internal Medicine (Rheumatology)
3710 SW US VETERANS HOSPITAL RD, P3MED
PORTLAND, OR 97239
Nurse Practitioner (Adult Health)
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239
Anesthesiology
3710 SW US VETERANS HOSPITAL RD
PORTLAND, OR 97239
Pharmacist (Pharmacotherapy)
3710 SW US VETERANS HOSPITAL RD, GP1P3PHAR
PORTLAND, OR 97239
Anesthesiology
3710 SW US VETERANS HOSPITAL RD, PORTLAND VAMC, P3 ANES
PORTLAND, OR 97239

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Amy Wagner's NPI number?

The NPI number for Amy Wagner is 1003827965. It was assigned to this individual provider in the NPPES registry on August 10, 2006.

Where is Amy Wagner located?

Amy Wagner practices at 3710 SW Us Veterans Hospital Rd V3-Satp, Portland, OR 97239. The listed phone number is (503) 220-8262.

What is Amy Wagner's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Amy Wagner enrolled in Medicare?

No. Amy Wagner has opted out of Medicare through September 4, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Amy Wagner accept?

Health plans from PacificSource Health Plans list Amy Wagner as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Amy Wagner was last updated on July 8, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.